Assessment of nutritional status and outcomes of nutrition support in paediatric patients admitted to an intensive care unit

Abstract

Malnutrition is common at hospital admission and tends to worsen during hospitalization. Despite its significant effect on clinical outcome, malnutrition is seldom recognized by health care professionals in hospitalized children. As critical illness has a major impact on nutritional status of children it is imperative to be aware of the nutritional status of the children at admission in order to direct the health care strategies towards the overall improvement of these little lives. Planning and implementation of appropriate nutrition support helps the patient to recover faster, prevent iatrogenic malnutrition and reduce length of hospitalization. Inadequate feeding leads to malnutrition and may increase the patient s risks of morbidity and mortality. The lack of systematic research and clinical trials on various aspects of nutritional assessment and nutrition support in the PICU is striking and makes it challenging to compile evidence based practice guidelines. Aim: The aim of the study was and#8213;To assess the nutritional status, implement a protocolized nutrition support and evaluate its effect on the nutritional outcome of subjects admitted to a paediatric intensive care unitand#8214;. Materials and Methods: The study was carried out in 260 paediatric subjects admitted to the Paediatric Intensive care units (PICU) in a multispecialty tertiary care hospital at Chennai, India. In addition to the routine assessment parameters, the subjective global assessment tool was used to assess the nutritional status of the subjects and interpreted using IAP and WHO reference standards. Results: Evaluation of the nutritional status of the subjects using W/A, W/H and H/A criteria revealed that a total of 49 % of the children were underweight, 40% were wasted and 52% were stunted. Underweight and stunting was predominant among infants in the age group of 1-6 months of age. The toddlers were more wasted than their other counterparts.